This dissertation explores the areas of healing and wellness within Indigenous communities on Turtle Island. By drawing on a decolonising approach to Indigenous health research, this study engaged 10 Indigenous healthcare practitioners in a dialogue regarding Indigenous worldviews; notions of wellness and wholistic health; critiques of psychiatry and psychiatric diagnoses; and the cultural strategies that Indigenous healthcare practitioners utilise while helping their clients through trauma, depression, and experiences of “parallel and multiple realities.” Importantly, this study addresses a gap in literature and puts forth a necessary contribution in regards to Indigenous peoples and psychiatry. Indigenous healthcare practitioners reveal their thoughts and strategies in relation to psychiatric diagnoses, cultural treatment, and psychotropic medication. The stories and strategies gathered during the interview dialogues created a broader discussion that is situated among the existing literature. This research found that Indigenous knowledge and experience was deeply embedded in the practises of Indigenous healthcare practitioners. The strategies presented by these practitioners offer purposeful and practical methods that originate from Indigenous worldviews, yet can be utilised by any practitioner that is seeking therapeutic strategies to help traumatised individuals and communities. Moreover, this research will be a particularly relevant resource for health policy initiatives, agency programming, and education and training institutes. Bringing forth Indigenous strategies for helping and healing is a vitally important contribution to the field of trauma work.

This study explored the meaning people with spinal cord injuries give to physical activity and recreation participation as they make the transition from the protected environment of hospital rehabilitation to the reality of returning to their homes and communities. The experiences of 4 individuals between 15 and 24 years of age who had sustained spinal cord injuries within the previous five years were captured using the phenomenological methods of semi-structured individual interviews, focus group interviews, photographs, and field notes. Rimmers (1999) model of health promotion for people with disabilities combined with Peters (1996) model of disablement provided the conceptual framework for the study and facilitated the interpretation of the findings. The participants indicated that physical activity was a very important component to living a psychologically, socially and physically healthy lifestyle following a spinal cord injury. A thematic analysis revealed three themes: (a) as my body heals, (b) learning to be me, and (3) getting back to life. The importance of physical activity in maintaining a healthy lifestyle following a spinal cord injury was reflected in stories of physical activity as a component of hospital rehabilitation, the importance of physical activity during the transition from the hospital to the challenges of returning home, and finally, engagement in community based physical activity. A gap in the continuity of physical activity opportunities during the transition from in-hospital rehabilitation to the return to the community was identified.

Mindfulness-based wellness education (MBWE) is an 8-week program teaching formal mindfulness practices as a foundation for cultivating an awareness of one’s health or ill-health in the physical, social, emotional, ecological, vocational, mental and spiritual domains of human existence. It is designed as a health promotion intervention for individuals who are at risk of developing stress related problems, such as is the case of human services professionals. This dissertation focuses on teachers-in-training. Two groups of teacher trainees completed MBWE as part of an elective course focusing on stress and burnout. In comparison to control participants, who completed other optional courses, MBWE participants experienced improvements in mindfulness, health, and teaching self-efficacy. In one group, the intervention was also effective in reducing psychological distress and augmenting satisfaction with life. Interviews with participants after graduation revealed that although they struggled with independent mindfulness practice, they benefited from their participation in the class, which led to specific health behavior changes such as increased physical activity. Some participants reported that they relied on their mindfulness practices in times of crisis; others shared the knowledge they learned with their students and observed that this was an effective and beneficial response to the needs of their classrooms. Ideas for future inquiries include the need to explore factors influencing participants’ responses to the MBWE program and how to support on-going practice.

This dissertation explores the areas of healing and wellness within Indigenous communities on Turtle Island. By drawing on a decolonising approach to Indigenous health research, this study engaged 10 Indigenous healthcare practitioners in a dialogue regarding Indigenous worldviews; notions of wellness and wholistic health; critiques of psychiatry and psychiatric diagnoses; and the cultural strategies that Indigenous healthcare practitioners utilise while helping their clients through trauma, depression, and experiences of “parallel and multiple realities.” Importantly, this study addresses a gap in literature and puts forth a necessary contribution in regards to Indigenous peoples and psychiatry. Indigenous healthcare practitioners reveal their thoughts and strategies in relation to psychiatric diagnoses, cultural treatment, and psychotropic medication. The stories and strategies gathered during the interview dialogues created a broader discussion that is situated among the existing literature. This research found that Indigenous knowledge and experience was deeply embedded in the practises of Indigenous healthcare practitioners. The strategies presented by these practitioners offer purposeful and practical methods that originate from Indigenous worldviews, yet can be utilised by any practitioner that is seeking therapeutic strategies to help traumatised individuals and communities. Moreover, this research will be a particularly relevant resource for health policy initiatives, agency programming, and education and training institutes. Bringing forth Indigenous strategies for helping and healing is a vitally important contribution to the field of trauma work.

Sexual experiences are an important part of everyday life, yet little research has taken place to understand it’s implication in the leisure realm. As leisure scholars adopt a holistic view of the individual, one’s sexual experiences remain a critical element devoid of empirical research. The current study examined the linkages between leisure and sexual experiences for six couples in the life stage of early adulthood. Findings revealed that relationally, couples conceptualized sexual experiences as a means to express love. At an individual level, it was clear that leisurely dimensions including intrinsic motivation, perceived freedom, involvement, arousal, mastery and spontaneity were present in some sexual experiences. This research provides support that sexual experiences can be plotted on Neulinger’s (1981) Leisure Continuum highlighting the work-like and/or leisurely aspects of relational sexual experiences.

Persons 65 years or older are the fastest growing demographic in Canada (Government of Canada, 2011) and the need for 24-hour care and LTC support will continue to rise. An association is typically drawn between death and dying and the movement into LTC homes. Leisure can alternatively be important for promoting “living” and supporting wellness in residents. The notion of “living” in LTC shifts emphasis away from illness and death to placing value on wellness. This participatory action research (PAR) study aims to understand wellness from residents’ perspectives and the role leisure plays in their wellness. PAR stakeholders (family/care partners, staff, and residents) collaboratively discuss how to best attain, interpret, and disseminate resident perspectives on wellness and required supports. The PAR process highlights the necessity for academics and practitioners to involve residents in decisions about their care experience. Guiding questions include: (1) What does wellness mean to residents living in LTC? (2) What does a ‘well’ LTC home look like to residents? (3) What is the nature of the relationship between leisure and wellness from a resident perspective? (4) How can those involved in LTC support resident wellness? From the perspectives of residents living in LTC homes, findings inform a resident wellness model and provide insights into how wellness and “well” LTC homes can be better supported. Thus, filling a gap in the literature and shifting focus to living ‘well’ in LTC.

The current study examined the influence of social cognitive variables on physical activity and proposed an intervention for an 8-week physical activity promotion program. Four specific components were examined: implementation intentions, goal commitment, barrier self-efficacy, and value. Participants included faculty and staff enrolled in a university Employee Wellness Program. Participants in the treatment group received goal-setting prompts focused on developing implementation intentions, identifying the value of outcome expectancies, and overcoming self-efficacy barriers. Participants in the control group did not receive goal-setting prompts. The use of goal-setting prompts did not result in significantly more minutes spent exercising. Overall, participants who received goal-setting prompts maintained their engagement in physical activity throughout the program, while participants in the control group steadily declined after week 5. For the treatment group, physical activity was dropping after the first week, but after receiving implementation-intentions prompts, physical activity increased. The use of implementation intentions should be further investigated. Additionally, the use of administering prompts throughout the complete program should be examined.

This study explored the meaning people with spinal cord injuries give to physical activity and recreation participation as they make the transition from the protected environment of hospital rehabilitation to the reality of returning to their homes and communities. The experiences of 4 individuals between 15 and 24 years of age who had sustained spinal cord injuries within the previous five years were captured using the phenomenological methods of semi-structured individual interviews, focus group interviews, photographs, and field notes. Rimmers (1999) model of health promotion for people with disabilities combined with Peters (1996) model of disablement provided the conceptual framework for the study and facilitated the interpretation of the findings. The participants indicated that physical activity was a very important component to living a psychologically, socially and physically healthy lifestyle following a spinal cord injury. A thematic analysis revealed three themes: (a) as my body heals, (b) learning to be me, and (3) getting back to life. The importance of physical activity in maintaining a healthy lifestyle following a spinal cord injury was reflected in stories of physical activity as a component of hospital rehabilitation, the importance of physical activity during the transition from the hospital to the challenges of returning home, and finally, engagement in community based physical activity. A gap in the continuity of physical activity opportunities during the transition from in-hospital rehabilitation to the return to the community was identified.

The practice of health self-management offers behavioral and problem-solving strategies that can effectively promote responsibility for one's own wellbeing, improve one's health outcomes, and decrease the cost of health services. Personal informatics applications support health self-management by allowing their users to easily track personal health information, and to review the changes and patterns in this information. Over the course of the past several years, I have pursued a research agenda centered on understanding how personal health informatics applications can further support the strategies of health self-management--specifically those relating to goal-management and behavior change. I began by developing a flexible personal informatics tool, called Salud!, that I could use to observe real-world goal management and behavior change strategies, as well as use to evaluate new interfaces designed to assist in goal management. Unlike existing personal informatics tools, Salud! allows users to self-define the information that they will track, which allows tracking of highly personal and meaningful data that may not be possible to track given other tools. It also enables users to share their account data with facilitators (e.g. fitness grainers, nutritionists, etc.) who can provide input and feedback. Salud! was built on top of an infrastructure consisting of a stack of modular services that make it easier for others to develop and/or evaluate a variety of personal informatics applications. Several research teams used this infrastructure to develop and deploy a variety of custom projects. Informal analysis of their efforts showed an unmet need for data storage and visualization services for home- and health-based sensor data. In order to design a goal management support tool for Salud!, I first, I conducted a meta-analysis of relevant research literature to cull a set of proven goal management strategies. The key outcome of this work was an operationalization of Action Plans--goal management strategies that are effective at supporting behavior change. I then deployed Salud! in two fitness-related contexts to observe and understand the breadth of health-related behavior change and goal management practices. Findings from these deployments showed that personal informatics tools are most helpful to individuals who are able to articulate short-term, actionable goals, and who are able to integrate self-tracking into their daily activities. The literature meta-analysis and the two Salud! deployments provided formative requirements for a goal management interaction that would both incorporate effective goal management strategies and support the breadth of real-world goals. I developed a model of the goal management process as the framework for such an interaction. This model enables goals to be represented, evaluated, and visualized, based on a wide range of user objectives and data collection strategies. Using this model, I was able to develop a set of interactions that allow users of Salud! to manage their personal goals within the application. The generalized goal management model shows the inherent difficulty in supporting open-ended, highly personalized goal management. To function generically, Salud! requires facilitator input to correctly process goals and meaningfully classify their attributes. However, for specific goals represented by specific data collection strategies, it is possible to fully- or semi-automate the goal management process. I ran a large-scale evaluation of Salud! with the goal management interaction to evaluate the effectiveness of a fully-automated goal management interaction. The evaluation consisted of a common health self-management intervention: a simple fitness program to increase participants' daily step count. The results of this evaluation suggest that the goal management interaction may improve the rate of goal realization among users who are initially less active and less confident in their ability to succeed. Additionally, this evaluation showed that, while it can significantly increase participants' step count, a fully automated fitness program is not as effective as traditional, instructor-led fitness programs. However, it is much easier to administer and much less resource intensive, showing that it can be utilized to rapidly evaluate concrete goal management strategies.

The purpose of this study was to examine the effectiveness of two models, namely an adaptable wellness programming model and an action research model, when creating and administering a stress management initiative for campus recreation settings that will have a positive effect on freshmen participants at the University of Tennessee. Eight freshmen from the University of Tennessee (6 females, 2 males) volunteered to complete a five week stress management initiative entitled the FROSH! (FResh Out of Stress, & Healthy!) Program which was based upon action research methodology. Program participants completed an exit interview and exit interview questionnaire after the program to determine if their levels of perceived stress had changed and to measure the effect that the program had on each individual. The Perceived Stress Scale was also administered before and after the program to detect any changes in perceived stress levels that participants experienced, but the sample size was too small to detect any significant changes in perceived stress levels. E. T. Stringer’s Categorizing and Coding procedure was used to decode responses from all meetings as well as from the exit interviews. Results indicate that the FROSH! Program was rewarding in various ways for participants, and 86% of participants said that their stress levels had lowered by the conclusion of the program. All participants thought that setting weekly goals was helpful in lowering their stress levels. Furthermore, the revised adaptable program model was perceived to be successful in creating the stress management initiative. It is recommended to increase the number of participants for future programs, and also to test the success of such action research-based wellness programs in campus recreation centers.